| NPI | 1093055626 |
|---|---|
| Former Name | ANNE M MALLORY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LPC-5177) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 10118) |
| 101YP2500X Counselor, Professional (Licence: ID LPC 5177) | |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2022-09-21 |